# FAIRVIEW FAMILY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184229809
- **Authorized official:** STEPHEN TRAGER DDS (OWNER)
- **Authorized official phone:** (317) 926-5467

## Contact information

- **Practice address:** 3195 W FAIRVIEW RD STE B, GREENWOOD, IN 46142-8499
- **Practice address phone:** (317) 887-0888
- **Mailing address:** 2291 N MERIDIAN ST, INDIANAPOLIS, IN 46208-5727
- **Mailing address phone:** (317) 926-5467
- **Mailing address fax:** (317) 926-6022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 12/01/2020
- **Last updated:** 12/01/2020